Dopamine, cognitive biases and assessment of certainty: A neurocognitive model of delusions

Annabel Broyd, Ryan P. Balzan, Todd Stephen Woodward, Paul P. Allen

Research output: Contribution to journalReview articlepeer-review

37 Citations (Scopus)


This paper examines the evidence that delusions can be explained within the framework of a neurocognitive model of how the brain assesses certainty. Here, ‘certainty’ refers to both low-level interpretations of one's environment and high-level (conscious) appraisals of one's beliefs and experiences. A model is proposed explaining how the brain systems responsible for assigning certainty might dysfunction, contributing to the cause and maintenance of delusional beliefs. It is suggested that delusions arise through a combination of perturbed striatal dopamine and aberrant salience as well as cognitive biases such as the tendency to jump to conclusions (JTC) and hypersalience of evidence-hypothesis matches. The role of emotion, stress, trauma and sociocultural factors in forming and modifying delusions is also considered. Understanding the mechanisms involved in forming and maintaining delusions has important clinical implications, as interventions that improve cognitive flexibility (e.g. cognitive remediation therapy and mindfulness training) could potentially attenuate neurocognitive processes.

Original languageEnglish
Pages (from-to)96-106
Number of pages11
JournalClinical Psychology Review
Publication statusPublished - 1 Jun 2017


  • Assigning certainty
  • Beliefs
  • Cognitive
  • Delusions
  • Dopamine
  • Neurobiological


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